Smart Discharges Program for children with sepsis in Uganda: a qualitative program evaluation

<br /><strong>Background:</strong> Pediatric sepsis continues to be a significant burden in low- and middle-income countries. Studies have shown that in-hospital mortality is equal to, and sometimes exceeds, mortality during the post-discharge period. These facts call for a concerted action to improve childhood survival following discharge from sepsis. The Smart Discharges Program uses a mobile health platform for risk stratification of children admitted with sepsis to target at-risk children and their caregivers for educational counseling at discharge and referrals and follow-up care during the vulnerable post-discharge period. Since 2017, this program has been enrolling children at four hospitals in Uganda (Mbarara, Masaka and Jinja Regional Referral Hospitals and Holy Innocents Children’s Hospital). However, the perceptions of the caregivers with regard to the SD Program are poorly understood. <br />

<br /><strong>Objectives:</strong> The purpose of the study is to explore the parents’/caregivers’ perceptions of the Smart Discharges Program in regard to its contribution to improved care post-discharge of children who have suffered from severe infections. Specific objectives include i) to describe parents'/caregivers' experiences receiving and using Smart Discharges care package; ii) to explore parents'/caregivers' perception of the barriers to access the care provided by Smart Discharges; and iii) to document the lessons learned and opportunities for improvement of Smart Discharges Program to improve discharge care for children who have suffered from sepsis.
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<br /><strong>Methods:</strong> A qualitative design using different approaches and methods will be adopted. We will enrol 64 parents/caregivers of children who have received care through the Smart Discharges Program and 8 implementation nurses involved in providing the care in this program at the four program sites. Seventy-two participants (64 parents/caregivers and 8 nurses) will take part in the study. Eight Focus Group Discussions (8 participants per FGD), and 8 interviews with program implementation nurses will be conducted. Audio files will be transcribed verbatim, translated into English and analyzed using Nvivo. Findings will contribute to improvement of post-discharge care in Uganda.<br />

<br /><strong>Ethics Declaration:</strong> We will obtain ethics approval from the University of British Columbia Children’s & Women’s Research Ethics Board in Canada as well as the relevant institutional review boards in Uganda. Administrative clearance will also be obtained from the respective hospitals. <br />